Objetivo: Relatar o processo diagnóstico da Lesão Central de Células Gigantes e as opções de terapias farmacológicas disponíveis como alternativa para o tratamento cirúrgico enquanto conduta de primeira escolha. Estudo de Caso: Paciente do sexo feminino, 24 anos, apresentava aumento de volume assintomático em região de corpo mandibular direito. A conduta inicial foi a realização da biópsia incisional e após a análise histológica foi necessário solicitar exames laboratoriais para distúrbios paratireoides a f im de descartar a possibilidade do Tumor Marrom. Os resultados se apresentaram dentro dos padrões de normalidade e uma vez elucidado o diagnóstico de Lesão Central de Células Gigantes foi iniciado o tratamento com injeções intralesionais de triancinolona. Com 09 meses do início do tratamento, a paciente encontra-se com remissão significativa da lesão e ao exame tomográfico observa-se neoformação óssea satisfatória. Considerações Finais: A Lesão Central de Células Gigantes demanda de um extenso processo diagnóstico e dispõe de tratamentos cirúrgicos e/ou farmacológicos, cabe ao profissional responsável pelo caso ponderar a melhor abordagem para cada paciente.

4-ETHYLSULPHONYLNAPHTHALENE-1 -SULPHONAMIDE (HPA) induces hyperplasia of the bladder epithelium in the rat and mouse (Paget, 1958;Sen Gupta, 1962). The hyperplasia arises within forty-eight hours of the first administration of the chemical (Bonser and Clayson, 1964) and with repeated dosing is still present after forty weeks (Sen Gupta, 1962). Carcinomas of the bladder were found in Ab x IF mice receiving the chemical for up to sixty-five weeks and were more prevalent in female than in male mice (Bonser and Clayson, 1964).The discovery of the carcinogenic action of HPA on mouse bladder epithelium was unusual in so far as the tests were undertaken following observation of the induction of hyperplasia. Other bladder carcinogens were found, more or less by chance, as a result of their action over long periods in man or experimental animals and their early effects have largely been ignored. The present report is an attempt to remedy this omission.Relatively few chemicals are known to induce bladder cancer in the experimental animal (Boyland, 1963). In some cases the absence of tumours may have been due to a failure to examine this organ with sufficient care. Therefore some hitherto unpublished long term tests in which the bladder has been adequately examined, are included in this paper in order to strengthen the comparison between the early effects of a chemical and the formation of tumours. MATERIALS AND METHODS Mice

IN 1958 Brimelow and Vasey were granted a patent for their invention of new sulphonamides, especially 4-ethylsulphonylnaphthalene-1-sulphonamide, which possessed potentially valuable therapeutic properties as anti-convulsants and diuretics. In that year Paget drew attention to an atypical hyperplasia of the urinary tract epithelium of the rat induced by administration of 4-ethylsulphonylnaphthalene-l-sulphonamide (Paget, 1958).Sen Gupta (1962a) confirmed Paget's finding in the rat and also showed the compound to be active on the mouse bladder epithelium of different strains. There was a remote possibility of activity in the renal pelvis of the rabbit. He called the compound HPA (hyperplastic agent). He also demonstrated that two analogous sulphonamides, 4-methylsulphonylnaphthalene-1-sulphonamide and 4-isopropylsulphonylnaphthalene-l-sulphonamide, were active hyperplastic agents. In the same year Sen Gupta (1962b) was able to demonstrate the ability of HPA to act as a co-carcinogen when added to the diet of mice bearing in their bladders pellets of the weak carcinogen 2-amino-1-naphthol hydrochloride.Recently Bonser and Clayson (1963) demonstrated the carcinogenic activity of this sulphonamide to the bladder epithelium of the mouse when 0.01 per cent was added to the normal diet over a period of weeks. Some of the induced carcinomas infiltrated the bladder wall and invaded the muscle layer.The present experiments were undertaken in an attempt to show whether the hyperplastic agent exerted its effect by virtue of its excretion in the urine.McDonald and Lund (1954) devised a method of forming isolated bladder pouches in the dog and showed that following oral administration of 2-naphthylamine tumours occurred only in the main bladder and not in the pouches, provided that the latter were completely isolated. From these experiments they inferred that the carcinogen was urine-borne. As the hyperplastic agent had not been shown to be effective in the dog (Sen Gupta, 1962a) it was decided to try to form isolated bladder pouches in the rat and thereafter to administer the chemical in suitable dosage by mouth. MATERIAL AND METHODSFemale Sheffield rats weighing from 200-250 g. were used. Under ether anaesthesia the urinary bladder was exposed and the dome distended by liquid * Permanent address: Hospital das Clinicas,

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